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Security, Legal and Ethical Aspects of Computerised Health Data in Europe

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Medical Informatics, e-Health

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Abstract

The European directive 95/46/CE has defined the legal framework of all personal data collection and treatment and the right of patients about the processing of their personal medical information. The development of telemedicine and domotics are real services provided to the patients but the raising new questions about the share of liability in case of medical litigation and the protection of patients’ privacy when a camera is permanently at home. Solutions protecting privacy may be found by using security tools based on cryptography and therefore then main technical principles must be known.

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References

  • Allaert FA, Le Teuff G, Quantin C et al (2004) The legal acknowledgement of the electronic signature: a key for a secure direct access of patients to their computerised medical record. Int J Med Inform 73(3):239–242

    Article  PubMed  CAS  Google Scholar 

  • Anonymous ‘Convention n°108 (28 January 1981) for the Protection of Individuals with regard to Automatic Processing of Personal Data’

    Google Scholar 

  • Anonymous ‘French law “Loi informatique et libertés”, Act n°78-17 of 6 January 1978, on information technology, data files and civil liberties’

    Google Scholar 

  • Anonymous ‘Post i-2010 priorities for new strategy for European information society (2010–2015).’ http://ec.europa.eu/information_society/eeurope/i2010/docs/post_i2010/090804_ipm_content.pdf

  • Anonymous ‘Since EHR systems may contain a large amount of data over a long period of time, the new European legal framework should also foresee, among other things, the need for a comprehensive logging and documentation of all processing steps that have taken place within the system, combined with regular internal checks and follow-up on correct authorization, and regular internal and external data protection auditing. See also European Commission Commission Recommendation of 2 July 2008 on cross-border interoperability of electronic health records’, C (2008) 3282 final, 2 July 2008, Point 14(k). It will also be an important challenge for legislators to guarantee that all groups in society (including single parents, homeless persons, the elderly and disabled, isolated communities, etc.) have equal access to electronic health records. See also European Commission, ‘e-Health – making healthcare better for European citizens: an action plan for a European e-Health Area’, COM (2004) 356 final, 30 April 2004, 15’

    Google Scholar 

  • Anonymous ‘Directive 95/46/EC on the protection of individuals with regard to the processing of personal data and on the free movement of such data’

    Google Scholar 

  • Armstrong BK, Kricker A (1999) Record linkage – a vision renewed. Aust N Z J Public Health 23(5):451–452

    Article  PubMed  CAS  Google Scholar 

  • Arney D, Venkatasubramanian KK, Sokolsky O et al (2011) Biomedical devices and systems security. Conf Proc IEEE Eng Med Biol Soc 2011:2376–2379

    PubMed  Google Scholar 

  • Bellare M, Canetti R, Krawczyck H (1996) ‘Message authentication using hash functions’, the HMAC construction. RSA Laboratories’CryptoBytes 2:1–5. http://www.cs.ucsd.edu/users/mihir/papers/hmac.html/

  • Blakely T, Woodward A, Salmond C (2000) Anonymous linkage of New Zealand mortality and census data. Aust N Z J Public Health 24(1):92–95

    Article  PubMed  CAS  Google Scholar 

  • Borst F, Allaert FA, Quantin C (2001) The Swiss solution for anonymously chaining patient files. Stud Health Technol Inform 84(Pt 2):1239–1241

    PubMed  CAS  Google Scholar 

  • Carretero S, et al (2012) Can technology-based services support long-term care challenges in home care?: analysis of evidence from social innovation good practices across the EU, in European Commission – Joint Research Centre. (http://www.epractice.eu/files/Can%20Technology-based%20Services%20support%20Long-term%20Care%20Challenges%20in%20Home%20Care_%20Analysis%20of%20Evidence%20from%20Social%20Innovation%20Good%20Practices%20across%20the%20EU_%20CARICT%20Project%20Summary%20Report_0.pdf)

  • Chen YY, Lu JC, Jan JK (2012) A secure EHR system based on hybrid clouds. J Med Syst 36(5):3375–3384

    Google Scholar 

  • Chryssanthou A, Varlamis I, Latsiou C (2011) A risk management model for securing virtual healthcare communities. Int J Electron Healthc 6(2–4):95–116

    PubMed  Google Scholar 

  • Churches T, Christen P (2004) Some methods for blindfolded record linkage. BMC Med Inform Decis Mak 4:9

    Article  PubMed  Google Scholar 

  • Coatrieux G, Quantin C, Allaert FA et al (2011a) Lossless watermarking of categorical attributes for verifying medical data base integrity. Conf Proc IEEE Eng Med Biol Soc 2011:8195–8198

    PubMed  CAS  Google Scholar 

  • Coatrieux G, Auverlot B, Roux C (2011b) Watermarking – a new way to bring evidence in case of telemedicine litigation. Stud Health Technol Inform 169:611–615

    PubMed  Google Scholar 

  • Cormen TH, Leiserson CE, Rivest RL, Stein C. Introduction to algorithms, 3rd edn. Edition Dunod. Collection: Sciences Sup

    Google Scholar 

  • Couris CM, Gutknecht C, Ecochard R et al (2006) Estimates of the number of cancer patients hospitalized in a geographic area using claims data without a unique personal identifier. Methods Inf Med 45(5):515–522

    PubMed  CAS  Google Scholar 

  • Das S, Kundu MK (2012) Effective management of medical information through a novel blind watermarking technique. J Med Syst 36(5):3339–3351

    Google Scholar 

  • Engelbrecht R, Hildebrand C, Jung E (1995) The smart card: an ideal tool for a computer-based patient record. Medinfo 8(Pt 1):344–348

    PubMed  Google Scholar 

  • Hsu CL, Lu CF (2012) A security and privacy preserving e-prescription system based on smart cards. J Med Syst 36(6):3637–3647

    Google Scholar 

  • Hustinx P (2009) Data protection in the light of the Lisbon Treaty and the consequences for present regulations. In: 11th conference on data protection and data security – DuD 2009, Berlin

    Google Scholar 

  • Jones PS, Meleis AI (1993) Health is empowerment. ANS Adv Nurs Sci 15(3):1–14

    PubMed  CAS  Google Scholar 

  • King T, Brankovic L, Gillard P (2012) Perspectives of Australian adults about protecting the privacy of their health information in statistical databases. Int J Med Inform 81(4):279–289

    Article  PubMed  Google Scholar 

  • Kun L et al (2007) Improving outcomes with interoperable EHRs and secure global health information infrastructure. Conf Proc IEEE Eng Med Biol Soc 2007:6159–6160

    PubMed  CAS  Google Scholar 

  • Laske C (1996) Legal liability issues in health care telematics. Med Inform Europe 34:942–945

    Google Scholar 

  • Lau DH (2002) Patient empowerment – a patient-centred approach to improve care. Hong Kong Med J 8(5):372–374

    PubMed  CAS  Google Scholar 

  • Mandl KD, Szolovits P, Kohane IS (2001) Public standards and patients’ control: how to keep electronic medical records accessible but private. BMJ 322(7281):283–287

    Article  PubMed  CAS  Google Scholar 

  • Morin E (2004) La méthode, tome 6: Ethique, ed. Le Seuil, Paris

    Google Scholar 

  • Quantin C, Benhamiche AM, Faivre J et al (1998a) How to ensure data security of an epidemiological follow-up: quality assessment of an anonymous record linkage procedure. Int J Med Inform 49(1):117–122

    Article  PubMed  CAS  Google Scholar 

  • Quantin C, Bouzelat H, Allaert FA et al (1998b) Automatic record hash coding and linkage for epidemiological follow-up data confidentiality. Methods Inf Med 37(3):271–277

    PubMed  CAS  Google Scholar 

  • Quantin C, Allaert FA, Gouyon B et al (2005a) Proposal for the creation of a European healthcare identifier. Stud Health Technol Inform 116:949–954

    PubMed  Google Scholar 

  • Quantin C, Binquet C, Allaert FA et al (2005b) Decision analysis for the assessment of a record linkage procedure: application to a perinatal network. Methods Inf Med 44(1):72–79

    PubMed  CAS  Google Scholar 

  • Quantin C, Allaert FA, Fassa M et al (2007a) How to manage secure direct access of European patients to their computerized medical record and personal medical record. Stud Health Technol Inform 127:246–255

    PubMed  Google Scholar 

  • Quantin C et al (2007b) Interoperability issues regarding patient identification in Europe. Conf Proc IEEE Eng Med Biol Soc 2007:6161

    PubMed  CAS  Google Scholar 

  • Quantin C, Trouessin G, Allaert FA et al (2008) Combining hashing and enciphering algorithms for epidemiological analysis of gathered data. Methods Inf Med 47(5):454–458

    PubMed  CAS  Google Scholar 

  • Quantin C, Coatrieux G, Allaert FA et al (2009) New advanced technologies to provide decentralised and secure access to medical records: case studies in oncology. Cancer Inform 7:217–229

    PubMed  Google Scholar 

  • Quantin C, Benzenine E, Allaert FA et al (2011a) Medical record search engines, using pseudonymised patient identity: an alternative to centralised medical records. Int J Med Inform 80(2):e6–e11

    Article  PubMed  Google Scholar 

  • Quantin C, Benzenine E, Auverlot B et al (2011b) Empowerment of patients over their personal health record implies sharing responsibility with the physician. Stud Health Technol Inform 165:68–73

    PubMed  Google Scholar 

  • Quantin C, Jaquet-Chiffelle DO, Coatrieux G et al (2011c) Medical record: systematic centralization versus secure on demand aggregation. BMC Med Inform Decis Mak 11:18

    Article  PubMed  Google Scholar 

  • Rey J, Douglass K (2012) Keys to securing data as a practitioner. J Med Pract Manage 27(4):203–205

    PubMed  Google Scholar 

  • Rialle V (2009) Quelques enjeux de l’éthique évaluative en gérontologie. Revue Francophone de Gériatrie et de Gérontologie 16(156):262–266

    Google Scholar 

  • Ricoeur P (1992) Oneself as another (trans. Blamey K), ed. University of Chicago Press, Chicago

    Google Scholar 

  • Rivest RL, Shamir A, Adleman L (1978) A method for obtaining digital signatures and public key cryptosystems. Commun ACM 2:10

    Google Scholar 

  • Ross SE, Lin CT (2003) The effects of promoting patient access to medical records: a review. J Am Med Inform Assoc 10(2):129–138

    Article  PubMed  Google Scholar 

  • Rostad L (2008) An initial model and a discussion of access control in patient controlled health records. Proceedings of the 2008 Third International Conference on Availability, Reliability and Security. IEEE Computer Society, Washington, DC, USA, pp 935–942

    Google Scholar 

  • Turchin MC, Hirschhorn JN (2012) Gencrypt: one-way cryptographic hashes to detect overlapping individuals across samples. Bioinformatics 28(6):886–888

    Article  PubMed  CAS  Google Scholar 

  • Vulliet-Tavernier S (2000) Discussion about anonymity in health data processing. Médecine et droit 40:1–4

    Article  Google Scholar 

  • Wei J, Hu X, Liu W (2012) An improved authentication scheme for telecare medicine information systems. J Med Syst 36(6):3597–3604

    Article  PubMed  Google Scholar 

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Quantin, C., Allaert, FA., Daniel, C., Lamas, E., Rialle, V. (2014). Security, Legal and Ethical Aspects of Computerised Health Data in Europe. In: Venot, A., Burgun, A., Quantin, C. (eds) Medical Informatics, e-Health. Health Informatics. Springer, Paris. https://doi.org/10.1007/978-2-8178-0478-1_11

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  • DOI: https://doi.org/10.1007/978-2-8178-0478-1_11

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